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Breech Position and Breech Birth

Topic Overview

What is breech position?

During most of pregnancy,
there is enough room in the
uterus for the baby (fetus) to
change position. By 36 weeks of pregnancy, most babies turn into a head-down
position. This is the normal and safest fetal position for birth.

But in about 4 out of 100 births, the baby doesn't naturally turn
head-down. Instead, the baby is in a breech
position.1 Babies in breech position usually must be
delivered by
C-section.

Frank breech. The
buttocks are in place to come out first during delivery. The legs are straight
up in front of the body, with the feet near the head. This is the most common
type of breech position.

Complete breech.
The buttocks are down near the birth canal. The knees are bent, and the feet
are near the buttocks.

Footling breech. One
leg or both legs are stretched out below the buttocks. The leg or legs are in place
to come out first during delivery.

What causes breech position?

Most of the time, there is no clear reason why the baby did not turn head-down.

In some cases, breech position may be linked to early labor, twins or more, problems with the uterus, or problems with the baby.2

What are the signs that your baby is in breech position?

You probably won't be able to feel whether your baby is breech. But if
you are 36 or more weeks pregnant and think you feel the baby's head pressing
high up in your belly or you feel kicking in your lower belly, see your
doctor for an exam.

How is a breech position diagnosed?

During a
routine exam late in your pregnancy, your doctor will feel your upper and lower
belly and may do a
fetal ultrasound to find out if your baby is breech.
Your doctor may also learn that your baby is breech when he or she checks your
cervix.

How is breech position treated?

Sometimes a doctor can turn a baby from a breech position to a head-down
position by using a procedure called an
external cephalic version. (If you are using a midwife and your baby is in breech position, your midwife will refer you to a doctor for this procedure.) If the baby can be turned
head-down before labor starts, you may be able to have a vaginal birth.

You also can ask your doctor if you can try certain positions at home
that may help turn your baby. This is called postural management. There is no research to prove that this works,
but it's not harmful. It may work for you.

It's normal to feel
disappointed and worried about a breech pregnancy, especially if the doctor has
tried to turn the baby without success. But most breech babies are healthy and
don't have problems after birth. Talk to your doctor if you're concerned about
your baby's health.

How is a breech baby delivered safely?

In most cases, a planned cesarean delivery (C-section) is safest for the baby. If your fetus is still in a breech position near your due date, your doctor will likely schedule a cesarean. If you are using a midwife, your midwife will refer you to a doctor for a scheduled C-section.

In rare cases, a cesarean breech birth may not be recommended or even possible. For instance, if a breech labor progresses too quickly, a vaginal birth may be the only option. During a twin birth in which the first twin is head-down and the second twin is breech, both babies may best be delivered vaginally.3

No matter what position a baby is in, every labor
and delivery is unique. Even though you and your doctor have a birth plan for
labor and delivery, plans can change. If something unexpected happens, your
doctor may need to make some quick decisions to keep you and your baby
safe.

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